Ten-year atherosclerotic cardiovascular disease risk score in post-menopausal women with low bone mineral density

BACKGROUND: Reports on the association between cardiovascular disease (CVD) risk and bone mineral density (BMD) remain inconsistent and hence more population-based studies on this subject are needed. AIMS: This cross-sectional study aimed to evaluate the association between bone mineral density (BMD) at the lumbar spine (L1-L4) and femoral neck (right and left) with 10-year atherosclerotic cardiovascular disease (ASCVD) risk scores in Saudi postmenopausal women. METHODS: A cohort of 1,450 postmenopausal women with risk factors for bone loss were analyzed using the data from the Chair for Biomarkers of Chronic Diseases (CBCD) Osteoporosis database. BMD at the lumbar spine and femoral neck was assessed using dual-energy X-ray absorptiometry (DXA). Anthropometric and biochemical parameters, including fasting glucose and lipid profiles, were measured. ASCVD risk scores were calculated using the ASCVD Risk Estimator Plus tool. BMD tertiles were analyzed for their association with ASCVD risk. RESULTS: Women with osteoporosis had significantly lower BMI, waist and hip circumferences, and metabolic dysfunction markers compared to those with normal BMD. Significant negative correlations were observed between ASCVD risk scores and BMD at femoral neck sites in women with osteopenia and osteoporosis. Multivariate logistic regression indicated that women in the lowest BMD tertiles had significantly higher odds of intermediate to high ASCVD risk scores, with adjusted odds ratios of 1.90 for the lumbar spine, 2.19 for the right femoral neck, and 2.04 for the left femoral neck. CONCLUSIONS: The study identified significant associations between lower BMD at the lumbar spine and femoral neck sites and elevated 10-year ASCVD risk scores in postmenopausal women, particularly among those with osteopenia and osteoporosis. These findings demonstrate the importance of assessing cardiovascular risk in women with low BMD to enable early prevention and management strategies.